Triple Airway Manoeuvre

Question 1

Indications

Answer 1

Patient requiring airway management

Question 2

Contraindications

Answer 2

Injury or anatomy prevents safe application

Question 3

Precautions

Answer 3

1. Spinally immobilised patients

2. Children and infants may require modified positioning

Question 4

Components

Answer 4

1. Prepare patient
   - Adult: approx 2cm pad below occiput
   - Larger child: supine with nothing
   - Newborn/infant/small child: 2cm pad below shoulders
2. Check airway
   - Clear and suction as required
3. Head Tilt, Chin Lift, Open Mouth
4. Jaw Thrust

Question 5

How does the triple airway manoeuvre enhance the assessment of the airway?

Answer 5

To pull the tongue and soft tissues from the back of the throat to achieve and maintain an open airway

Question 6

Why is it important to avoid hyperextension of the head?

Answer 6

Hyperextension can flatten the trachea

Question 7

Why should head positioning be varied when assessing the airway of a small child compared to a medium child?

Answer 7

• Small children have a larger occiput than adults proportional to body size. As a result, they do not need to have their head elevated in the same fashion
• Medium children (primary school-11) are likely best managed supine with their head on the same surface plane as body

Question 8

How would you position an infant or small child’s airway

Answer 8

• Larger occiput compared to adults proportional to body size. Best managed with a small pad under the shoulders. Occiput can push chin towards chest, potentially occluding airway in supine position